Post Traumatic Stress Disorder
Conditions
Keywords
Cognitive Processing Therapy (CPT), Lived experience stress, Lived Experience Adapted Protocol (LEAP), Veterans
Brief summary
Populations facing health disparities include groups with significantly higher rates of posttraumatic stress disorder than the general population who frequently experience lived experience stress, which may complicate posttraumatic stress disorder symptom presentations. However, there are currently no posttraumatic stress disorder treatments designed to meet the unique needs of these individuals. The proposed study will pilot an adaptation of Cognitive Processing Therapy (a gold-standard treatment for posttraumatic stress disorder) that has been modified to incorporate the impact of lived experience stress as an additional treatment target. This project has the potential to advance our understanding of how to enhance Cognitive Processing Therapy in order to optimize posttraumatic stress disorder treatment response and mitigate health disparities.
Detailed description
This study will occur in two phases. Phase 1 will involve refining Cognitive Processing Therapy Lived Experience Adapted Protocol (CPT-LEAP) and includes beta testing of CPT-LEAP (n=6). Phase 2 will involve a pilot RCT in which participants (n=52) will be randomized (1:1) to standard CPT or CPT-LEAP. The investigators anticipate 26 participants will be enrolled in each treatment arm.
Interventions
BEHAVIORALStandard CPT
CPT focuses on teaching skills to identify and challenge PTSD-maintaining maladaptive beliefs related to the trauma itself, the world, and oneself. Worksheets and assignments are given between each session.
BEHAVIORALCPT-LEAP
CPT-LEAP frames each session in relation to beliefs about both traumatic and lived experience stressors and their interactions and impacts, including not only beliefs about oneself, others, and the world, but also one's identity, and use of relevant examples throughout the protocol.
Sponsors
Boston University
National Institute of Mental Health (NIMH)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Current diagnosis of PTSD * Self-identification as a sexual or gender minority (SGM) individual * Endorsement of SGM stress experiences with moderate distress * For patients who take psychiatric medication, stable dose one month prior to enrollment * Reside in Massachusetts.
Exclusion criteria
* Current active suicidal or homicidal ideation with intent or plan * Unstable bipolar disorder/current mania * Unstable psychotic disorder/current psychosis * Current severe substance use that warrants immediate medical attention * Cognitive impairment or organic disorder (e.g., advanced dementia, severe traumatic brain injury) that impairs ability to complete CPT procedures * Past completion of CPT or current trauma-focused treatment * Unwillingness to consent to audio or video recording of assessment and treatment sessions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Post traumatic stress disorder symptoms (PTSD) | immediately after treatment, 3 months | Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 (CAPS-5). The CAPS-5 includes 20 items assessing PTSD symptom severity. Total scores range from 0-80 with higher scores indicating more severe PTSD symptoms. |
Countries
United States
Contacts
CONTACTCara Herbitter, PhD, MPH
PRINCIPAL_INVESTIGATORCara Herbitter, PhD, MPH
Psychiatry CABUSM and National Center for PTSD, VA Boston Healthcare System
Outcome results
None listed